Hoffman on right track, but more rationing isn’t the answer

Commentary from Canadians for Sustainable Medicare

Health Minister Sarah Hoffman is on the right track when she states: “We simply cannot continue increasing spending on health care in this province the way we have done in the past.”

In the early 1980s, the Alberta government spent 30 cents of every taxpayer dollar on publicly funded health care, i.e., Medicare. Today it is 50 cents and, if nothing changes, it will be 70 cents in just 30 years. That will means less government support for low-income citizens, community housing, seniors’ programs, education, roads, etc.

The Alberta government, therefore, wants to “bend the cost curve” by reducing the annual increase in Medicare spending to 2% from 6%.

If the government is successful, the result will be more rationing of publicly funded health care. Why? Because factors such population growth, an aging population and inflation will mean fewer real dollars to pay for more demand. Moreover, the strength of the USA dollar will hurt when purchasing medical supplies from our next-door neighbor.

For the individual patient, more rationing will mean even longer wait times in the hospital emergency room [ER], even longer wait times to see a specialist, and even longer wait times for non-emergent and scheduled elective surgery.

“Scheduled elective surgery” is misleading because the phase suggests it doesn’t matter whether or not the patient receives care. Not true! For example, a person who requires a hip replacement or a knee replacement will be classified as “elective” because the patient’s condition is not life threatening. The surgery has to be scheduled.

On the other hand, waiting months and months for a hip or knee replacement can result in being unable to work, with major implications for the family budget and even a person’s ability to keep their job.

For the most part, Medicare does a good job in providing true “emergency” care. Urgency/urgent or “non-emergent” care is a step below emergency/emergent care. Urgent care is also being rationed, e.g., lab tests, diagnostic imaging [DI] such as MRIs and ultrasounds, and chemotherapy [“chemo”] and radiation therapy for cancer.

Access to primary care – traditionally being treated by a family physician [FP] – is, at best, uncertain as the government commits to a future in which physicians are paid differently and health care teams replace family physicians.

Albertans must not become the victims of more government rationing. They deserve choices and options north of the 49th parallel. Not everyone can afford to travel to the United States. Not everyone is a WCB injured worker who, under the Canada Health Act, can jump to the front of line.

Minister Hoffman argues, “New and better models for paying doctors have been developed.” So, too, new and better models for providing health care have been developed – and all have a mix of public and private delivery and a mix of public and private funding.

Those who support the continuation of the Medicare public monopoly must answer these questions: “Why has no other industrialized country in the world copied Canada? Why is Canada the only outlier?”

Tommy Douglas argued that a person’s or a family’s financial situation should not be a barrier to health care. Nor should a government’s financial situation be a barrier to a person’s health care.

But when a barrier to care occurs through rationing, Albertans should have the choice to use their own money [and private insurance] and have the private sector do what Medicare cannot do – provide the care that a person needs.

This would also help to address the unemployment and under-employment of many physicians, especially new graduates, who cannot have meaningful careers in the publicly funded system.

For example, hospital budgets effectively restrict the number of specialists who can have operating room [OR] privileges. If patients had the option to choose private health care, it would provide employment, reduce wait lists in the public system, and bolster the economy.

Understandably, publicly funded health care and Tommy Douglas hold very special significance for the NDP. Douglas’ passion for publicly funded health care was personal and honorable. The Alberta government, however, has a moral obligation to put the health needs of each and every Albertan ahead of the Douglas legacy.

Minister Hoffman is targeting costs in hospital acute care, prescription pharmaceuticals and physician incomes. In doing so, she is not dealing with the whole patient. Her challenge and her opportunity are to bring Medicare in Alberta into the 21st century.

 

Canada’s government-run health care system – Medicare -- is a monopoly that prohibits private hospital and private physician care. Medicare is a subpar performer, ranking 10th among 11 advanced countries. Canadians deserve much better! Patients deserve timely access to quality care and choice of hospitals and physicians. Taxpayers deserve much more value for their tax dollars.

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